Question: Recently, I have had several instances where I have had difficulty swallowing food. The last episode was a little frightening. My throat almost felt as though it was closing. I would appreciate any advice you can give me. I am 80 yrs of age and have rheumatoid arthritis. I take 70 mg. of Fosamax every other week, an anti-inflammatory every day and 12 mg of methotrexate once a week.

Dr. Hibberd's Answer:

You are taking potent immune suppressant medication as well as an agent known to interfere with esophageal function in some patients. Ask your doctor to at least temporarily stop Fosamax, and consider undergoing an upper gastro-intestinal endoscopy (EGD) to exclude a structural problem with stricture, erosion, ulceration or malignancy. Motility (muscular and dyscoordination) disorders of the esophagus without an obstruction are common as we age. Specific treatments are available depending upon the location, extent and precipitating conditions behind the disorder. Sometimes, a very simple treatment will correct motility, while other cases can be more involved. Let me know how things turn out.